<div>
<style>
body{
	overflow-x:hidden;
}
.consignee-box .consignee-radio {
    display: inline-block;
}
</style>

<div class="ui-portlet-header">
			      <span class="title">编辑发票申请</span>            
			</div>
<span style="color: green">（爱护地球、支持环保，我们建议您积累多次消费后再一起开票 ^_^）</span>

{{$this->Form->create('OrderInvoice',array('class'=>'form-horizontal','id'=>"OrderInvoiceAddForm",'role'=>'form'))}}
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoiceName">发票抬头：</label>
		<div class="col-sm-9 controls">
			{{$this->Form->hidden('id')}}
			{{$this->Form->hidden('referer',array('value'=>'/order_invoices/mine'))}}
			{{$this->Form->input('name',array('class'=>'form-control','div'=>false,'required'=>'required','label'=>false))}}
			<small style="margin: 0;color:red;">请确保公司名字准确无误，抬头填写错误造成打印发票错误的不可重开</small>
		</div>
	</div>
	
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoicePrice">税号：</label>
		<div class="col-sm-9 controls number">
			{{$this->Form->input('ivc_nsrcode',array('class'=>'form-control','div'=>false,'label'=>false))}}
			<small style="margin: 0;color:red;">国家税务规定，企业必须填写税号，发票才能入账，否则是废票。税号提供错误造成打印发票错误的不可重开。</small>
		</div>
	</div>
	
	<div class="form-group">
		<label class="col-sm-3 control-label">开票项目：</label>
		<div class="col-sm-9 controls" style="line-height: 40px;">
			专业技术服务
		</div>
	</div>
	
	
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoicePrice">发票金额：</label>
		<div class="col-sm-9 controls number">
			{{$this->Form->input('invoice_value',array('class'=>'form-control','div'=>false,'required'=>'required','label'=>false))}}
		</div>
	</div>
	
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoiceReceiver">收件人：</label>
		<div class="col-sm-9 controls number">
			{{$this->Form->input('receiver',array('class'=>'form-control','div'=>false,'required'=>'required','label'=>false))}}
		</div>
	</div>
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoiceAddress">省市区：</label>
		<div class="col-sm-9 controls form-inline">
			{{$this->Form->input('province',array('class'=>'form-control','div'=>false,'required'=>'required','style'=>'width: 150px;','label'=>false))}}&nbsp;
			{{$this->Form->input('city',array('class'=>'form-control','div'=>false,'required'=>'required','style'=>'width: 150px;','label'=>false))}}&nbsp;
			{{$this->Form->input('area',array('class'=>'form-control','div'=>false,'required'=>'required','style'=>'width: 150px;','label'=>false))}}
		</div>
	</div>
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoiceAddress">收件地址：</label>
		<div class="col-sm-9 controls number">
			{{$this->Form->input('address',array('class'=>'form-control','div'=>false,'required'=>'required','label'=>false))}}
		</div>
	</div>
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoiceMobile">联系电话：</label>
		<div class="col-sm-9 controls number">
			{{$this->Form->input('mobile',array('class'=>'form-control','div'=>false,'required'=>'required','label'=>false))}}
		</div>
	</div>
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoicePostcode">邮编：</label>
		<div class="col-sm-9 controls number">
			{{$this->Form->input('postcode',array('class'=>'form-control','div'=>false,'label'=>false))}}
		</div>
	</div>
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoicePostcode">备注：</label>
		<div class="col-sm-9 controls number">
			{{$this->Form->input('content',array('class'=>'form-control','type'=>'textarea','div'=>false,'label'=>false))}}
		</div>
	</div>
	<hr>
	<div class="form-group">
		<label class="col-sm-3 control-label" for="OrderInvoiceName"></label>
		<div class="col-sm-9"><input class="btn btn-primary" type="submit" value="提交"></div>
	</div>
</form>
</div>